Pseudo Electrolyte Imbalances related to Diabetes

[fem]

Hi.

Can anyone that can explain what "pseudo electrolyte imbalances" are?

Our professor (who has a doctorate degree in nursing) discussed this in class.

Our lecture was on diabetes.

My best guess is that in acute diabetes, there may be hypovolemia (Patient is dry, volume depleted). So there are more particles of electrolytes in relationship to the volume of fluid.

Does that sound correct?

If my train of thought is correct, so normal lab value for osmolality is 280-300 mOsm/kg where 270 is "wet" and "310" is dry. And normal lab for K+ potassium is 3.5-5 mEq/L

So now what???

Would the lab paperwork show K+ potassium at 6 mEq/L when osmolality is 310 mOsm/kg? If the actual number of particles are the same, yet the patient is not volume depleted or dry (let's say 300 mOsm/kg), would the lab paperwork show K+ at, for example, 4.5 mEq/L?

I don't know, I think I'm lost!

Fem (student nurse in ADN program)

[BostonFNP, APRN]

Not quite correct, and this is a rather difficult one to describe.

Pseudohyponatremia is, in a nutshell, a laboratory error in how sodium is measured that occurs in cases of profound hyperlipidemia, hyperprotienemia, or hyperglycemia. It is also referred to as isotonic hyponatremia. Basically sodium has been replaced as the major osmotic factor in the blood. True hyponatremia is hypotonic: as sodium is the major osmole, when it's missing the serum osmolality falls. In the case of pseudohyponatremia, the osmolality remains normal as sodium has been replaced by another osmole.

Pseudohypokalemia or pseudohyperkalemia are other "lab" errors that occur when a blood sample is improperly handled prior to measurement.

You are talking about dilutional imbalances which are also possible in DKA.